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Med Surg 1 > Integumentary > Flashcards

Integumentary Flashcards

1
Q

Plaque vs bulla

A

Plaque: solid raised lesion, > 1cm
Bulla: fluid filled blister

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2
Q

Macule

A

Flat, nonpalpable (similar to freckle)

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3
Q

Papule

A

Palpable solid raised lesion (ex: mole)

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4
Q

Vesicle

A

Small raised area (< 1cm diameter) (ex: chickenpox, shingles)

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5
Q

Med term for hair loss

A

Alopecia

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6
Q

What does spoon-shaped nails usually indicate?

A

Anemia

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7
Q

What does thick yellow nails usually indicate?

A

Fungal infection

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8
Q

If doing skin testing for diagnostic tests, what should you always have in the room and why?

A

Always have a crash cart in the room b/c the things that the pt is getting are probably the ones that they are allergic to

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9
Q

What should the dressing be when applied on skin?

A

Open wet dressings, can be sterile or clean

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10
Q

What does open wet dressing help with?

A

Decrease inflammation, cleanse and dry wounds, promote drainage of infected area

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11
Q

How often should you use the open wet dressings?

A

Dressing should be on the patient for 15-30 mintues, reapply after 3-4 hours as ordered

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12
Q

What is balneotherapy?

A

Hot baths, remember to always apply lubrication after

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13
Q

What does Burow’s solution do got wet dressings?

A

Relieve rashes, help stop the growth of bacteria and fungus

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14
Q

If patient gets chill after 20 minutes of wet dressing, what should you do?

A

Remove the dressing and cover patient up with a warm blanket. Next time should cover non-dressed area with warm blanket.

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15
Q

Pressure injuries patho

A

Pressure against skin (pressure, friction, shear), tissue anoxia (loss of O2)

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16
Q

What does Braden Scale’s scores mean?

A

Lower score = higher risk of skin breakdown

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17
Q

Physician ordered to debride a pressure ulcer in 1 hour, what is the nurse’s first action?
1. Ask physician to order antibiotics for treating pressure ulcer
2. Hand hygiene
3. Premedicate the pt 45 min prior to procedure
4. Gather supplies

A

3! Premedicate

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18
Q

Can you use an autolytic debridement on an infected wound?

A

No, b/c it’s for pressure ulcers not for wounds, and it means 自溶性的

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19
Q

Types of dermatitis - contact

A

Acute or chronic.
Caused by contact with irritation or allergen.
Ex: poison ivy, perfume, medication

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20
Q

Types of dermatitis - atopic（特应性）

A

Chronic.
Inherited, may be associated with resp allergies or asthma.
Bright red macules, papules, hyperpigmented areas

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21
Q

Types of dermatitis - seborrheic（脂溢性）

A

Chronic.
Inflammatory, too much production of sebaceous secretions.
Can appear as dry, moist, or greasy scales, yellow or pink-yellow crusts, redness, and dry flakiness

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22
Q

Is it easier or harder to get dermatitis the second time?

A

Easier

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23
Q

What can you use to treat dermatits?

A

Antihistamine
Analgesics
Steroids
Wet dressings
Colloidal oatmeal baths
Antipruritics（止痒药）

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24
Q

Psoriasis patho

A

Inflammatory disorder, caused by overproduction of epidermal cells, cause silvery scales

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25
Q

What types of medication can aggravate psoriasis?

A

Beta-blockers, lithium, antimalarial agents

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26
Q

What can aggravate psoriasis other than meds?

A

Stress, alcohol and smoking, cold weather, skin trauma

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27
Q

Normal vs psoriasis skin cell divide times

A

Normal: every 27 days
Psoriasis: every 4-5 days

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28
Q

S/s of psoriasis

A

Red papules, silvery scales, itching

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29
Q

Where does psoriasis usually occur?

A

Elbows, knees, scalp, torso, genitals

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30
Q

How do clothes affect psoriasis patients?

A

Clothes can rub on their skin and can be very uncomfortable

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31
Q

What can psoriasis lead to?

A

Infection, psoriasis arthritis, nail changes, lymphadenopathy（淋巴结肿大）

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32
Q

Interventions for psoriasis

A

Corticosteroids, keratolytics (topical salicylate acid), vit D creams, UV light, tub baths, Tar Preparations (anti myotic: slows down cell division)

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33
Q

Why does psoriasis patients need to drink a lot of water?

A

To keep skin hydrated

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34
Q

Herpes Simplex Virus (HSV) patho

A

Viral/primary infection, ex: direct contact/sex, resp droplet, fluid exposure…

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35
Q

HSV1 vs HSV2

A

HSV1: above waist, no cure (b/c more easier to retrigger)
HSV2: below waist, has a cure (ex: genital herpes)

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36
Q

HSVs have no s/s when first occurred b/c?

A

It usually lies dormant（处于休眠状态）

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37
Q

What can trigger herpes?

A

Stress

38
Q

Prodromal phase of HSV

A

S/s first appearing before getting severe, can be contagious for 2-4 days before crust form

39
Q

If no tx, how long does HSV lesions heal?

A

1-4 weeks

40
Q

HSV s/s

A

Burning, tingling, pustules burning itching pain, contagious until crusts form

41
Q

Interventions for HSV

A

No complete cure, antiviral, avoid triggers for reoccurrence.
Antibiotics can treat secondary infection

42
Q

Herpes Zoster (Shingles) patho

A

Acute inflammation/infection occurs after chickenpox.
Reduced immune function: elderly, AIDs, immunosuppressed
Painful vesicles, follows nerve distribution, usually one-sided

43
Q

Herpes Zoster (Shingles) most common area

A

Start from the lower back, comes around the front following the nerve

44
Q

What can Herpes Zonster lead to?

A

Sepsis
Hyperesthesia (increased sensitivity to the skin)
Ophthalmic herpes zoster
Postherpetic neuralgia
Persistent dermatomal pain (painful blisters and rashes along the line of distribution)

45
Q

Interventions for herpes zoster

A
  1. Acyclovir (Zovirax) (IV, oral, topical) (has to start within 72 hours of onset of symptoms)
  2. Analgesics
  3. Anticonvulsants/antidepressants (for neuropathic pain)
  4. Antihistamines
  5. Corticosteroids (used in combination of antivirals, not by itself)
  6. Antibiotics (secondary infection)
  7. Can use cold compresses or take cool baths to calm the nerves (not pregnant women b/c body is more sensitive)
46
Q

fungal infections patho

A

Direct contact with fungus, overgrowth with antibiotic therapy, grows in warm moist environment

47
Q

What is tinea?

A

癣, skin/fungal infections

48
Q

Interventions for fungal infections

A

Keep skin clean and dry
Topical antifungals
Oral antifungals (fluconazole (most common))
Corticosteroids
Teach to avoid spread

49
Q

Cellulitis patho

A

Inflammation of skin and connective tissue.
Infection (ex: MRSA, streptococcus)
Open wound/trauma
Or the cause can be unknown

50
Q

Cellulitis s/s

A

Warm, red, edema, pain, tender, fever, lymphadenopathy

51
Q

What to do when you have a cellulitis pt come in?

A

Outline where cellulitis started, have a baseline
Measure at least daily so you can tell if meds are working
Can apply warm compress to increase circulation

52
Q

Interventions for cellulitis

A

Antibiotics (topical, systemic)
Debridement
Elevate area to reduce swelling

53
Q

Why can’t a cellulitis patient get a CT scan with contrast?

A

b/c they already have fluids

54
Q

What should you monitor for cellulitis patient?

A

Monitor for sepsis and monitor the area for progress

55
Q

Acne Vulgaris patho

A

Increased sebum production, overload and clog pilosebaceous ducts cause comedones (open: blackheads; closed: whiteheads), hormone changes

56
Q

Where do blackheads come from?

A

Lipid and malignant pigment.
Popping can cause scarring

57
Q

Interventions for acne vulgaris

A

Vitamin A acid (a type of retinoid)
Antibiotics (very severe cases)
Isotretinoin (less severe)
Estrogen therapy (hormone)
Benzoyl peroxide
They usually take 3-6 weeks before seeing improvement

58
Q

Pediculosis patho

A

Infestation by lice, transmitted by direct contact

59
Q

3 types of pediculosis

A

Capitis: head lice
Corporis: body lice
Pubis: pubic lice

60
Q

Pediculosis s/s

A

Itching, rash, presence of lice, nits (eggs), and excreta (feces)

61
Q

Pt education on pediculosis

A

Self-medication: pyrethrin (Rid)
Removal of nits: that very think metal comb
Clean clothes and objects
Inspect family and friends: b/c it’s contagious

62
Q

how should patient wash clothes if they have pediculosis (lice)?

A

Wash clothes separately from other people and use extremely hot water.
Unwashable (hats…) needs to be sealed in a bag and put in garage for 10 days

63
Q

How long does it take dice to die without human contact?

A

1-3 days

64
Q

Does shampoo and lotion get rid of nits?

A

They kill nits but don’t remove them, so need the special thin metal comb to remove nits

65
Q

Scabies patho

A

Sarcoptes scabiei mites burrow into skin.
Caused by contact with infected clothing or animals

66
Q

Difference between pediculosis and scabies

A

Pediculosis doesn’t affect animals, but scabies do

67
Q

When does symptom start after contact for scabies?

A

4 weeks after contact

68
Q

Scabies s/s

A

Itching, rash (small, scattered, papules), burrows, short brown wavy lines on skin

69
Q

Interventions for scabies

A

Topical scabicides (permethrin, crotamiton)
Antipruritics（止痒药）

70
Q

How long without human contact will scabies die?

A

< 24 hours

71
Q

Patient education for scabies

A

Self-medication
Warm, soapy baths
Treat family members and animals
Wash clothes and linens separately
Itching may continue 2 weeks after tx

72
Q

Basal cell carcinoma

A

Most common type of skin cancer

73
Q

Squamous cell carcinoma

A

Lower lip, neck, tongue, head, posterior surfaces of hands

74
Q

Malignant melanoma

A

Usually developed from a mole, higher mortality rate

75
Q

What is something you can educate the patient on if they have malignant skin lesions?

A

Do yearly head to toe checks and make sure there are no changes to the moles

76
Q

What to educate patients on prevention of malignant skin lesions?

A
  1. Limit exposure to UV light
  2. Sunscreen, long sleeves
  3. Report any changes in moles (size, borders, colors)
77
Q

Why is fluid important for burns?

A

b/c the first 48h after burns: fluid shifts, leads to hypovolemia, which can lead to shock

78
Q

Rule of nines for adults

A

Face head neck: 9%
Back: 18
Front: 18
L and R arm: 9 + 9
Genital: 1
L and R leg: 18 + 18

79
Q

Rule of nines for children

A

Face head neck: 18%
Back: 18
Front: 18
L and R arms: 9 + 9
Genital: 1
L and R leg: 13.5 + 13.5

80
Q

1st~2nd degree burn

A

Epidermis.
Bright red to pink, should blanch, has serum built blister
Sensitive to air and touch
Takes 7-10 days to heal

81
Q

2nd~3rd degree burn

A

1/2~7/8 of dermis.
Pink to light red or white color, blancheable, soft
Sensitive, but includes pain to pressure b/c exposed nerve ending

82
Q

How long does it take skin grafting to heal?

A

14-21 days

83
Q

3rd~4th degree burns

A

All skin layers are through and go to bone and muscle.
Skin firm and leathery, no pain b/c all nerve endings are destroyed
This will need skin grafting

84
Q

Contact burns ex

A

Hot metal, hot grease, hot E cigarettes

85
Q

Scalding burn

A

Hot liquid, < 5/>65/clumpy

86
Q

Electrical burns

A

Most serious burns b/c bones have resistance to alzheimer’s so cause more damage

87
Q

Interventions for major burns (emergent stage)

A

This is when pt first come in and was burnt.
1. ABCs (make sure this is stable)
2. Stop the burning process
3. Stabilize related injuries
4. IV fluids
5. Pain control

88
Q

Split-thickness skin graft (STSG)

A

Epidermis and partial of dermis prone to chronic break down of continuous…?

89
Q

Full thickness skin graft (FTSG)

A

Color match, more likely to grow hair, but take longer to heal at the donor site.

90
Q

What is escharotomy

A

Skin too hypertrophy and thick, make relief cuts, increase circulation

91
Q

What position does burnt patient like to be in?

A

They like when their extremities are in a contractured position.

Med Surg 1 (3 decks)

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